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The Difference of Microorganism and Antibiotics Resistance between Adults and Children with Urinary Tract Infection
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Hyung Jong Nam, Seung Chan Jeong, Jong Youn Yi, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2012;7(2):136-141. Published online October 31, 2012
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 Abstract
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- Purpose
Urinary tract infection (UTI) is one of the most common infectious diseases in children and adults. It is widely known that most UTI is caused by E. coli. In most cases for those who underwent UTIs, empirical antibiotics were treatment of choice. But resistance of empirical antibiotics is increasing gradually. The proper use of antibiotics is essential in the clinical field. We evaluated the antibiotic resistance of organisms causing UTIs in children and adults patients to provide the proper use of empirical antibiotics.
Materials and Methods: From January 2011 to December 2011, 749 cases (mean age was 27.9±30.2years) who underwent positive urinary culture tests were evaluated. The age, sex, results of urine dipstick and microscopic tests, urine culture, and antibiotics resistance were reviewed.
Results: 460 men and 289 women were evaluated. Adults were 310 cases (41.4%) and children were 439 cases (58.6%). Pathogens from the results of urine culture were E. coli (35.7%), Enterococcus species(25.8%), Klepsiella (12.9%). Antibiotics resistance rate of all pathogens was 29.8% and Pseudomonas(36.1%), with E. coli (32.8%) having the highest resistance rate of all. Ampicillin (61.8%), trimethoprim/sulfamethoxazole (42.6%), and penicillin (39.4%) showed higher resistance rates than other antibiotics. The multi-drug resistance rate was 17.8% in total, adults were 17.4%, and children were 18.1%. Female urine RBC and urine WBC counts were ssociated with UTIs from a pathogen which has resistance at to at least one of the antibiotics in adults. On the other hand, older age, urine leukocyte esterase and urine RBC count was associated with antibiotics resistance in children.
Conclusions: Gram positive microorganisms including E. coli were the most common pathogen of UTIs both in adults and children. Therefore, quinolones and cephalosporins are widely used in UTIs, however antibiotic sensitivity was reduced in this study and there was no difference in adults and children. The sensitivity and drug resistance were changing steadily, affecting many factors and various pathogens gave rise to UTIs. Therefore considerations of many factors of sensitivity to antibiotics are needed.(Korean J UTII 2012;7:136-141)
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Trial for Clinical Guideline of the Use of Prophylactic Antibiotics in Pediatric Urologic Outpatient Surgery
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Hyung Jong Nam, Seung Chan Jeong, Mi Yeon Kong, Keum Seob Lee, Sang Don Lee
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Korean J Urogenit Tract Infect Inflamm 2012;7(1):50-55. Published online April 30, 2012
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- "Purpose: Proper use of antibiotics is essential in the clinical field. The overuse of antibiotics can be one of the causes for resistance. However, there is a lack of guideline to a valid method of prophylactic antibiotics in surgery. We evaluated the evidence on the suitable prophylactic antibiotics usage to prevent perioperative infection, when performing pediatric urologic outpatient surgery. Materials and Methods: From December 2010 to may 2011, 70 cases (mean age was 3.5±3.23 years) who underwent outpatient operation approached inguinal or scrotal incision were evaluated. In group 1, intravenous antibiotic prophylaxis was done only preoperatively. In group 2, intravenous antibiotics were administrated pre- and post-operative, each. In group 3, beside pre- and post-operative intravenous antibiotic prophylaxis, additional oral antibiotics were medicated for 3 days after discharge from the hospital. Further, in group 4, beside pre- and post-operative intravenous antibiotic prophylaxis, oral medication was administered until 7 days after discharge. Skin redness, pain, wound dehiscence, fever, gastrointestinal disturbance, and etc., were examined postoperatively. Results: Slight skin redness was observed in 4 cases (23.5%), 2 cases (10.5%), 1 case (7.1%), and 0 case (0.0%) in each group, but there is no need to treatment. There is no case who feels pain on the incision site of each group. Wound dehiscence occurred in one case in group 1 (5.9%) and group 3 (7.1%), respectively. There were no association with wound infection between each group, and wound infection was recovered spontaneously. Two cases (11.8%), 1 case (5.3%), 0 case(0.0%), and 3 cases (15.0%) complained with fever in each group. Diarrhea was observed in 2 cases (13.3%) and 4 cases (20.0%) in group 3 and 4, respectively. Conclusions: There were no differences in prophylactic effect to prevent infection in each group. Group 1 showed a lower incidence of diarrhea than group 3 or 4, but other adverse effects were not different among the groups. Therefore, it is sufficient to use antibiotics preoperatively for prophylactic purpose in pediatric urologic outpatient surgery."
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